Caregiving goes digital - and lets Boomers age in place

Dec. 5, 2013
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Song Pak, who is 80, sits in his massage chair to watch TV. It has a small Lively transmitter attached. Lively's remote units sense movement by the owner and can alert loved ones if something is not trending normally. / Dan MacMedan, USA TODAY

by Marco della Cava, USA TODAY

by Marco della Cava, USA TODAY

Steadily and relentlessly, a feeling of anxiety spread among the four Pak sisters as they tried in vain to call their 80-year-old father, Song Pak.

"We were really starting to worry, because our mom was visiting us and he was alone," says Suzy Pak, 43, a financial consultant from San Francisco, whose siblings also live far from their childhood home near Santa Barbara. "Just before we called the police, he finally called us. He'd been gardening all day in the yard. So we decided we had to do something."

A few weeks ago, the sisters swooped into action and bought their father Lively, a $149 wireless monitoring kit whose six small accelerometers detect movement.

"Now they know how I'm getting along," says Song, a retired urologist, who has sensors on his keychain, refrigerator and even on his favorite TV-watching chair. His daughters can check their activity patterns via the company's secure website. "I see it as a safety net. And more than anything, it gives us all peace of mind."

The Pak family is on the leading edge of a technological wave of global significance. As multiple generations gather under one roof to celebrate Thanksgiving this week, conversations inevitably will turn to caring for seniors. While nothing beats the human touch, health care innovators, researchers and educators predict that gadgets will soon turn the home into a medical nanny, keeping tabs on everything from pill-taking routines to signs of imminent crises.

Imagine bottle caps that glow when it's time to take medicine, chairs that take your vital signs and even carpets that analyze walking patterns and anticipate physical degeneration and mental infirmity. All are here or coming soon and will be a boon to the nation's 78 million Baby Boomers - those born from 1946 to 1964 - who are facing the prospect of aging with a shrinking population of caregivers.

"Over the next few decades, Boomers will push this (tech) trend partly both because they are very independent, but also because in the same time frame we'll see fewer paid and unpaid caregivers," says Jason Tester, research director for the non-profit Institute for the Future, citing a recent AARP report detailing that in 2010 there were 7.2 middle-age caregivers for every 80-year-old, but by 2050 that number will plummet to 2.9.

"With fewer people to watch over tomorrow's seniors, some will move into digitally connected retirement homes, while others will simply retrofit their own homes," Tester says. "The home will serve as an early detection system. Research shows that even small changes in daily habits can hint at serious problems to come."

Even if today the number of adults watching over senior parents remains high, those same time-pressed adults are looking for any help they can get: Nearly 1 in 5 Americans are family caregivers, whose free services are valued at $375 billion a year.

SAVING MONEY, SAVING LIVES

For seniors, the benefits of an idealized medical smart home are physical, psychological and emotional. Aging in place means continuing with familiar routines while health data are wirelessly relayed to doctors, caregivers and concerned family. Routine yet time-consuming and often health-jeopardizing visits to doctors' offices can be avoided.

For society, the bonuses include significantly reduced health care costs and happier elders.

"There's a big push to help seniors live independently, from technological innovations to cities organizing themselves in ways that cater to an older population," says David Ryan, an Intel manager currently based in Beijing as director of China's Aging Friendly Cities Initiative.

"China will soon have as many seniors as the U.S. has people," says Ryan, noting that New York recently won an international award for its efforts to render its city more senior-friendly. "There's an interest in helping people live harmoniously, but there are also big costs savings inherent in helping people stay healthy and safe longer."

But the challenges in this arena are just as impressive as the potential pluses, experts say. There's the matter of products from different companies with different health-monitoring functions effectively talking to each other and caregivers on the same platform. Tack on set-up hurdles inherent in any tech gadget, and privacy issues innate to products that traffic in sensitive personal data.

And then there's the M-word, monitoring, with its Cold War intimations of illicit peeping.

"There's a visceral reaction many people have to being monitored," says Stephen Intille, associate professor at Northeastern University's College of Computer and Information Sciences and a leading researcher in the field of personal health informatics. "We need to stay away from stigmatizing these innovations. The better way to think of them is like advanced answering machines that go in the homes of the seniors and their families as well. They should be seen as devices that link people together."

But seamlessness is the key, Intille says, citing an experiment he oversaw in which a subject was placed in a monitored-home but wound up trying to "game the system" out of defiance. Unobtrusive sensors "have a lot of potential, because Boomers especially will want to stay at home as they grow old," he says. "That's worth money, and that's where the market comes from."

Big money. Today's Boomers have amassed an estimated wealth totaling $7 trillion, about 70% of the total net worth of American households. In fact, this powerful consumer group already is happily spending on tech products that keep tabs on health, notably bracelets such as Fitbit and Nike Fuel.

This trend suggests Boomers likely will have few issues welcoming and paying for networked in-home health care monitoring systems. That perhaps explains the significant leap in venture capital funds directed at health care information technology companies - about $955 million last year, up from $343 million three years ago, according to the MoneyTree Report from PricewaterhouseCoopers and the National Venture Capital Association.

'WHO'S PAYING?'

But if there are profits to be made in this space, they may take some time to roll in, says Lisa Suennen, who since 1998 has helped steer investments in health care tech firms for Psilos Group Managers out of the firm's Bay Area offices.

"One of the big issues here is, who's paying?" says Suennen, noting that beyond the cost of the product and often its installation, there are typically recurring monthly data-collection fees. "Unfortunately, with our health care system most of the people who are financially invested in patients are also non-incented to care for patients."

Suennen says consumers will embrace in-home technologies precisely because they can potentially save them money on the cost of unnecessary doctors visits. "Is this all a good idea? Yes. Will we be there in 10 years? Maybe. In 20, probably," she says. "But from an investment point of view, that's a long time horizon."

Nevertheless, many companies are leaping into the breach, some diving like Lively into the direct-to-consumer pool. GlowCap fits most standard prescription bottles and uses light and sound to signal the user that it's time to take a pill. Sharp's Health Care Support Chair, which was unveiled in October at the tech confab CEATEC in Japan (where a staggering 25% of its 127 million citizens are older than 65, compared with 13% of Americans), is a $6,000 throne that can test and relay blood pressure and other vitals in one quick sitting.

Even more futuristic is a carpet woven from optical fibers that analyzes footstep patterns to predict whether someone may soon fall.

"Its advantages are both that the carpet is not intrusive into the person's environment, and that you can't cheat it," says Patricia Scully, senior lecturer in sensor instrumentation at the University of Manchester in England, who led the so-dubbed magic carpet project. "Besides simply detecting whether you are up and about, it can also analyze changes in someone's gait, which can give a sense of physical deterioration."

Scully says if developed on a large scale, the cost of the carpet would drop from its research price of $160-per-square-foot, as compared with $3 per foot for average household carpet. "We're hoping to come to an arrangement and start clinical trials," she says.

Working on a more massive scale is Qualcomm Life, whose 2net Platform is meant to gather and relay data from a range of medical monitoring devices.

"The easier it is to get whatever devices you own connected and networked to the cloud, the faster this all will take off," says Qualcomm Life CEO Rick Valencia, adding that the company is supporting a new graduate program in Wireless Health at Case Western Reserve University in Cleveland. "Too many products require you to undertake a small IT project at home."

Another behemoth wading into this area is Intel-GE Care Innovations. While the company's QuietCare monitoring system is aimed at health care facilities, Connect Caregiver, currently in early release, is a Web-accessible set of family caregiving tools that help adult-children oversee the daily medical and social routines of their aging parents.

"With Boomers being as mobile as they are, we're going to see monitoring expand far beyond the home itself," says Sean Slovenski, CEO of Care Innovations. "Home could be home, or it could be a second home, or a rental home in another country. We'll see devices that trail with us. Five to 10 years from now, it could be an all-in-one device. But technology has to catch up to the dream."

HOMEY TECH

When Iggy Fanlo conjured up Lively, the one-time derivatives trader at Morgan Stanley wanted to address the fact that in-home sensors were either priced too high, looked far too drab and institutional, and often required professional installation, all big barriers to entry for consumers. His solution was to make things childishly simple.

Lively, which comes with two months of cell-based connectivity (after which it costs $19.95 a month), is a do-it-yourself affair that asks users to simply stick quarter-sized accelerometers onto pill boxes, kitchen and refrigerator doors and other telltale items. During a trial in Sarasota, one user placed a sensor on a peanut butter jar. "She knew that if that was moved daily, everything was fine," says Fanlo with a laugh.

Besides providing authorized users access to a subject's comings and goings, the service also includes a twice-monthly LivelyGram, a small pamphlet mailed to the home featuring messages and photos chosen by family members. While it may seem like a small old-school perk, LivelyGram is already a favorite of Pak and his wife Mary, 73.

"It's a nice extra gift, seeing pictures of my grandkids come in the mail," he says.

For her part, daughter Suzy says she, her sisters and her mother - who often spends time at a new family condo near her children and grandchildren, while her homebody husband often remains at home down south - sleep easier knowing they can eavesdrop on a man they love without alarming him.

Suzy says it's a fine line with aging parents between caring and prodding.

"When you worry, your mind goes to the worst place, and you maybe bug them more than you should," she says. "Certainly having this technology in their home is weird, in that it's so specific I know when dad opened the fridge. But, it's weird in a good way."